Rapiya Bongwekazi, Khuzwayo Nelisiwe, Asher Laura, Brooke-Sumner Carrie
Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Mental Health, Alcohol, Substance Use & Tobacco Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa.
BMC Psychiatry. 2025 Jul 16;25(1):706. doi: 10.1186/s12888-025-06989-9.
In low- and middle-income countries (LMIC) such as South Africa, people with severe mental health conditions (SMHC) typically reside with family members, who serve as their primary caregivers. This study aimed to explore the lived experiences, needs and coping strategies of caregivers with a family member with SMHC in a low-resource setting in South Africa, and their perspectives on the provision of a support group programme.
An exploratory qualitative study was conducted, which included 22 in-depth individual interviews, 15 of them being females and 7 males ranging from 26 to 72 years of age. These caregivers were recruited through the service user presenting at the health facility. The interview guide covered caregiving experiences, coping strategies, perceptions on recovery, and acceptability of peer-led mutual support groups. Written informed consent was obtained before conducting interviews. Interviews were audio recorded, translated from isiXhosa to English and transcribed. Thematic analysis using NVivo 12 was used to analyze findings.
Caregivers reported being socially excluded from family and community gatherings, as well as experiencing financial and emotional hardship because of their responsibilities. This influenced their overall well-being and ability to cope. Inadequate time for their own social activities and fulfilment were frequently described, and this was linked to their level of responsibility for the needs of others in their homes, as caregiving obligations were rarely shared among family members. Although some caregivers had developed ways to cope, such as hobbies and spiritual endeavours, some nevertheless reported less healthy coping strategies, including alcohol use. Whilst most caregivers indicated they would be interested in a peer-led mutual support programme, some said they would not be able to participate because of work or other responsibilities.
Caregivers of people with SMHC in South Africa face considerable challenges, and supportive interventions are needed. Peer-led mutual support groups may hold the potential for providing this support.
在南非等低收入和中等收入国家（LMIC），患有严重精神健康状况（SMHC）的人通常与家庭成员住在一起，这些家庭成员是他们的主要照顾者。本研究旨在探讨在南非资源匮乏地区，照顾患有SMHC家庭成员的照顾者的生活经历、需求和应对策略，以及他们对提供支持小组计划的看法。
进行了一项探索性定性研究，包括22次深入的个人访谈，其中15名女性和7名男性，年龄在26至72岁之间。这些照顾者是通过在医疗机构就诊的服务使用者招募的。访谈指南涵盖了照顾经历、应对策略、对康复的看法以及同伴主导的互助小组的可接受性。在进行访谈之前获得了书面知情同意。访谈进行了录音，从科萨语翻译成英语并转录。使用NVivo 12进行主题分析以分析研究结果。
照顾者报告称在社交上被排除在家庭和社区聚会之外，并且由于他们的责任而经历经济和情感上的困难。这影响了他们的整体幸福感和应对能力。经常有人提到他们自己的社交活动和实现自我的时间不足，这与他们对家庭中他人需求的责任程度有关，因为照顾义务很少在家庭成员之间分担。尽管一些照顾者已经找到了应对方法，如爱好和精神追求，但仍有一些人报告了不太健康的应对策略，包括饮酒。虽然大多数照顾者表示他们对同伴主导的互助计划感兴趣，但一些人表示由于工作或其他责任无法参加。
南非患有SMHC的人的照顾者面临相当大的挑战，需要支持性干预措施。同伴主导的互助小组可能有提供这种支持的潜力。
